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Abstract
Objective To investigate associations between socioeconomic status (SES) indicators (education, job position, income, multidimensional index) and the genesis of chronic low back pain (CLBP).
Design Longitudinal field study (baseline and 6-month follow-up).
Setting Four medical clinics across Germany.
Participants 352 people were included according to the following criteria: (1) between 18 and 65 years of age, (2) intermittent pain and (3) an understanding of the study and the ability to answer a questionnaire without help. Exclusion criteria were: (1) pregnancy, (2) inability to stand upright, (3) inability to give sick leave information, (4) signs of serious spinal pathology, (5) acute pain in the past 7 days or (6) an incomplete SES indicators questionnaire.
Outcome measures Subjective intensity and disability of CLBP.
Results Analysis showed that job position was the best single predictor of CLBP intensity, followed by a multidimensional index. Education and income had no significant association with intensity. Subjective disability was best predicted by job position, succeeded by the multidimensional index and education, while income again had no significant association.
Conclusion The results showed that SES indicators have different strong associations with the genesis of CLBP and should therefore not be used interchangeably. Job position was found to be the single most important indicator. These results could be helpful in the planning of back pain care programmes, but in general, more research on the relationship between SES and health outcomes is needed.
- epidemiology
- social medicine
- preventive medicine
- public health
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Footnotes
Contributors All authors substantially contributed to the conception and realisation of this article. MF conceived and wrote the first draft of this manuscript and provided statistical analysis. JDWH and P-MW revised the manuscript. P-MW was responsible for the psychometric design, analysis plan and conceived the social methods of the multicentre study. All authors read and approved the final manuscript.
Funding This study is funded by the German Federal Institute of Sport Science on behalf of the Federal Ministry of the Interior of Germany. It is conducted within MiSpEx–the National Research Network for Medicine in Spine Exercise (grant-number: 080102A/11-14).
Competing interests None declared.
Patient consent Not required.
Ethics approval The study was approved by the Independent Ethics Committee of University of Potsdam (Ethics approval 36/2011).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data available.